A Glimpse at State Health Exchange Enrollment

The Obama administration is touting the success of the health law’s open enrollment, which signed up at least 7.5 million Americans for health coverage through the online insurance marketplaces. But the experience varied according to states and Families USA brought together five state exchange directors Thursday to talk about what they’ve seen so far. These states – Kentucky, New York, Washington, California and Connecticut — all had functioning exchanges and pursued that health law’s Medicaid expansion.

Bill Nold, deputy executive director at the Office of the Kentucky Health Benefit Exchange, said that there were 2,000 new enrollments on March 31 alone. So far, his office has counted 400,000 new enrollees, 315,000 of whom signed up for Medicaid. He expects those numbers to continue to go up until April 11 — when his state’s enrollment extension ends. In a last-ditch effort to up enrollment, he added, the state sent out 30,000 emails to people who had started an application but had not finished.

He said 33 percent of the Kentuckians who bought plans on the exchange were younger than 35.

In Connecticut, of the 197,878 new enrollees, 76,597 enrolled with a private insurance policy offered on the exchange and 121,281enrolled in Medicaid. Since open enrollment began, there were over 801,509 unique visitors to the website. The Access Health CT call center answered more than 366,975 calls.

Meanwhile, in New York, an estimated 80 percent of the 39,000 people who enrolled for coverage in the final days of open enrollment previously did not have insurance, according to Donna Frescatore, executive director of the New York State of Health.

And, though there are not yet national numbers on how many people have actually paid their first bill, Richard K. Onizuka from the Washington Health Benefit Exchange offered a fairly positive picture, saying all of Washington state’s 146,000 new enrollees already paid their premiums because it was built into the sign-up process. Almost twice as many people, 268,000, gained Medicaid coverage, he added, and 8,000 people signed up on March 31.

The numbers from state officials are similar to results from an April 9 RAND study, which estimated that 9.3 million people gained insurance as a result of the law. Most of this increase, the researchers found, came from new Medicaid beneficiaries and enrollment in employer plans. Although a total of 3.9 million people enrolled in marketplace plans, only 1.4 million of these individuals were previously uninsured. Of the 40.7 million who were uninsured in 2013, 14.5 million gained coverage, but 5.2 million of the insured lost coverage, for a net gain in coverage of approximately 9.3 million.

The directors agreed that it will be months before the results of the health law roll out are clear. Still, other observers see doubt in these early figures.

“They’re not making a dent in the uninsured — 9.3 million gained coverage, but most of those were in the employer market, and few were in exchange market so whether they’re coming near the objective to reduce the uninsured through exchanges is the question,” said Robert Laszewski, president of Health Policy and Strategy Associates.

Pressed by Republican House members, directors of troubled state insurance exchanges said Thursday that they could fix continuing Obamacare glitches with grant money they have already received and would not ask for federal bailouts.
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